Psychological Intervention in Catastrophes

  • Jul 26, 2021
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Psychological Intervention in Catastrophes

Today's society is highly sensitized by the impact of catastrophes. The security of the most developed countries has been repeatedly challenged by tragic events, especially terrorist violence. Events such as the attack of September 11, 2001 on the Twin Towers of Nueva York, March 11, 2004 in Madrid, or July 7, 2005 in London have shocked opinion world.

On the other hand, in Spain, it is also worth mentioning other types of disasters, such as air accidents, such as the GermanWings in 2015 or the Valencia metro in 2006, leaving 144 and 47 dead respectively. In situations of this type, we cannot eliminate the pain that a family member feels for a loved one who has passed away, but we can accompany you and help you through those bitter moments, we can make you understand what is happening to you and, above all, hear it. We cannot avoid the scenes of pain, nor the manifestations of anger or indignation, but we can channel and muffle them. The objective of this article is to inform about the psychological intervention activities in disaster situations.

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Index

  1. Crisis, emergency, disaster and catastrophe
  2. General planning of the intervention
  3. The population in need of care
  4. Intervention teams
  5. Place and time of the intervention
  6. goals
  7. Principles of the intervention
  8. Psychological intervention. functions and tasks
  9. Psychological intervention with affected / relatives
  10. Psychological support for rescue technicians

Crisis, emergency, disaster and catastrophe.

They are concepts that are used interchangeably (this is the case in this article) and that share certain similarities. Among them, those involving the loss or threat of life or property, in addition to disturbing the sense of community and causing adverse consequences for the survivors. On the other hand, they require a non-delayed intervention (they are emergencies). They also share that similar psychological reactions appear in front of them, that which are unpredictable and accidental and, therefore, cause surprise, defenselessness and destabilization. Despite all these similarities, there are also quantitative differences:

  • Emergency it would be the situation that is resolved with local medical and assistance resources. Examples of emergencies are found in the continuous interventions of the health services that cover traffic accidents.
  • More serious is the situation of disaster (without going into the types that exist) for which a greater infrastructure is needed and in which there is a greater number of injured, damaged and entails a higher economic cost, supposing an alarm for the population.
  • Finally they talk about catastrophe Referring to a massive disaster, with destructive consequences that covers a greater extension, it involves a great human, material and coordination effort. Disasters, with their consequences of horror and suffering, cause social alarm and raise the need for intervention to remedy, as far as possible, the damage caused. Intervention, in a catastrophic situation, requires a careful preparation process. Teams (of a multidisciplinary nature) are necessary, properly formed and trained to intervene in any situation.

However, these differences are very arbitrary and mainly concern economic and organizational aspects.

General planning of the intervention.

First, the general framework of the context in which the intervention is carried out must be planned. Planning should meet a series of requirements:

  • a) Be flexible to be able to adapt differentially to each situation. No two catastrophes are identical.
  • b) Include an evolutionary or temporal perspective. The catastrophe situation is a dynamic process that evolves over time, sometimes very quickly and unexpectedly. Interventional measures that may be helpful in the early stages may not be helpful, or even harmful, in later stages.

On these basic principles, the planning process should try answer a series of general questions like the ones below:

  • a) Who should the intervention be aimed at? That is, the population in need of psychological care.
  • b) Who should carry out the different interventions? Professionals and teams that must carry out the different interventions.
  • c) When and where should it be intervened? Most suitable place and time for each type of intervention.
  • d) Objectives of the intervention? Short, medium and long-term objectives must be set, which must be covered by the different interventions.
  • e) What principles should the intervention follow? That is, what requirements must you meet.
  • f) What means are available? The planning of the intervention process must be adapted to the means or resources (personal and material) available, as well as to the possibilities of action.
Psychological Intervention in Catastrophes - General planning of the intervention

The population in need of care.

In principle, anyone involved in a disaster, including relief teams and leaders, can be psychologically affected. No one is totally immune, in principle, to the effects of the catastrophe. Most of those involved experience, to a greater or lesser extent, painful emotions (fear, fear, insecurity, uncertainty, worry, grief, pain, etc.), which are reactions normally expected in an abnormal (exceptional) situation such as catastrophe. They are going to need a more specific psychological intervention:

  • a) People who have suffered physical injuries of consideration or that without having suffered significant physical injuries, they are psychologically very affected by the catastrophic event. They will require treatment to alleviate their current symptoms and prevent subsequent sequelae.
  • b) Subjects who need psychological help to face the painful losses suffered: people, (colleagues, family, friends... ), materials (home, household goods), social (work, social role).
  • c) Participants in rescue teams (health workers, firefighters, psychologists, security forces ...). All personnel involved in a disaster, from rescue services, volunteers and the members of the psychosocial team themselves is subjected to a strong psychological impact, so it is important that these people also receive the psychological support they need to through group techniques that favor emotional ventilation and facilitate coping strategies in critical situations (debriefing).

Intervention teams.

Faced with a disaster, as a psychosocial intervention, given the diversity of needs that arise and that can have a significant effect on psychological distress (basic needs, security, information, psychological support ...) a multidisciplinary action is proposed, that is, setting up a team made up of psychologists, social workers, health personnel and others who may be needed more promptly, such as religious representatives, translators, etc. Acting in this field requires a diversified team of professionals according to the different levels of intervention:

  • a) After the impact, at the scene of the disaster, relief teams can carry out important psychological work providing physical security, an examination that allows to rule out serious physical injuries, shelter, food, information (of your situation and that of yours), guidance, reassurance and support.
  • b) At a later stage, already in safe conditions, far from the real threat of the catastrophe, a variable proportion of those affected have mental disorders or the risk of developing them subsequently. This group is a tributary of a more specialized mental health intervention to be carried out by a team of professionals, preferably interdisciplinary, including the different specialists in the field of mental health (doctors, psychologists, psychiatrists, nurses, social workers ...), suitably trained, trained and who form a consistent team with wide availability to act in different situations of emergency.

Place and time of the intervention.

The first measures must be carried out as early as possible and in the safe place closest to the disaster area. It is intended to recover as many as possible of those affected in the shortest possible time. The exceptional situation created after the disaster calls for exceptional measures as well. An attempt should be made to ensure that these potentially recoverable subjects are reinstated and occupied as soon as possible. Are used elementary and simple measurements What:

  • Ensure minimal resting conditions for them.
  • Offer them hydration and nutrition.
  • Provide them with the right information on what they should and should not do.
  • Reassure them, allow them to release their emotions.
  • Raise awareness to stay active and busy.

All of this must be done promoting the expectations of the subject's recovery, ensuring that the The pain you experience is a transient and recoverable normal reaction to the serious situation you have experienced. Psychiatric labels should be avoided using language appropriate to the subject's ability to understand.

At a later stage, psychological support teams will pay attention to individuals evacuated by severe psychopathological alterations and high-risk populations, to anticipate the appearance of post-traumatic sequelae subsequent.

Goals.

The planning of a care intervention should set short, medium and long-term objectives, the latter assimilable by other care teams.

  • Short term: close in time and place to the catastrophic event, it is intended to alleviate the suffering of subject and accelerate the natural process of recovery after the painful impact of a traumatic event.
  • Medium term: the primary interest is focused on the prevention of delayed psychic sequelae and the evolution towards post-traumatic stress disorder.

In summary, psychological intervention in disasters is aimed at mitigating or alleviating suffering psychological of those affected and to prevent the worsening of the symptoms, developing actions that prevent their chronification.

Principles of the intervention.

The intervention should meet the requirements of immediacy, proximity, simplicity and expectation of a speedy recovery. The experience of military organizations has highlighted the importance of these measures, which constitute the shortened version of Solomon's treatment of the "reaction to combat stress" (Solomon, 1944) called:

  • Proximity: psychological care must be carried out in the scenarios close to the disaster (mortuary, hospitals etc.), to avoid pathologizing the situation, transferring those affected to a hospital, mental health center, etc.
  • Immediacy: the sooner the intervention is carried out, the less likely there are to develop future psychopathologies, such as Post Traumatic Stress Disorder.
  • Expectations: It is important to convey positive information to the affected person about their ability to cope with the situation, and insist on the idea that he is undergoing normal reactions to abnormal situations (Event Traumatic).
  • It is also indispensable convey positive expectations on a quick return to their role or function prior to the event, thus enhancing their self-esteem and their coping strategies.
  • Simplicity. Use of simple and brief techniques. Treatment should generally be short in time and last no more than four to seven days. The use of a structured environment and simple measures such as safe accommodation, clean clothes, drink, food, rest, simple occupations supervised, together with the possibility of talking about your experience in a group that understands you is enough to accelerate the recovery of the subject affected.

Psychological intervention. functions and tasks.

Depending on the type of affected population, we can talk about:

  • Psychological intervention with affected and family members: psychological support, enhance social support and coping capacity.
  • Psychological intervention with intervention groups: advice on self-protection measures (shifts, breaks, emotional ventilation).

Psychological intervention with affected / relatives.

They are actions that are aimed at the following objectives:

Reassure the subject

Explaining the meaning and scope of his symptoms, especially making him see that it is a transitory reaction to the situation experienced. Likewise, we must make him see that all these reactions are normal and unavoidable in a situation like this and that he should not try to find logical explanations for what happened. A simple relaxation technique can help. If the anxiety is intolerable for the patient or creates a risk situation (personal or for the group) can be resorted to the administration of a tranquilizer drug, as discussed more go ahead. In the case of a survivor of a catastrophe, reassurance must be given, providing the subjects with the assurance that they are safe and physically undamaged.

Promote the release of emotional tension caused by the disaster

This release should be encouraged, allowing the subject to speak and express her emotions (crying spells, discharges of verbal aggressiveness). Empathic listening is necessary, without pronouncing value judgments, helping to vent and vent contained emotions. This can help reduce the risk of post-traumatic sequelae.

Activate external resources to the subject (social, work and family support)

Social support is an important factor in reducing the impact of a traumatic event. Social support can be provided both by colleagues, others affected or by family members. People in the environment who have been affected by the same traumatic situation are in the best situation to understand those affected, sometimes their support and advice is decisive for the resolution of the crisis. In general, the attitudes that are recommended to the relatives or friends of the affected subject consist of simple measures such as:

  • Keep you from feeling lonely: accompany him, spend time with him, pay attention to him.
  • Listen to you and reassure you about her irrational fears, assuring her that she is safe and, above all, allowing her emotional relief, such as releasing the crying or contained rage.
  • It is also necessary facilitate rest, helping them with daily tasks and responsibilities.
  • Respect their silence and privacy. Each person tends to elaborate situations according to their personal way of being and may need privacy and silence. These attitudes must be understood and accepted by the environment.

Activate the internal resources of the subject (coping strategies).

The affected subject must return to their daily routine and try to organize their activities for the days after the attack or accident. To do this, you must follow these guidelines: Set small goals. Make small everyday decisions. Confront places and situations as soon as possible that remind you of what has happened. There may be difficulties concentrating at work. It is advisable to talk to bosses and colleagues about what happened so that they can understand it. Try to get enough rest and sleep (in situations like this it is necessary to sleep more than usual).

Psychological support for rescue technicians.

During the rescue work of the technicians it will be necessary to be attentive to the manifestations of stress. Among these technicians we have:

  • Sanitary.
  • Firemen.
  • Soldiers.
  • Psychologists
  • Social workers.
  • Security forces.

When we detect some professional who is suffering from this reaction, we must follow the following sequence:

  1. Remove the affected technician from the workplace to a place without aggressive stimuli.
  2. Ask about his status.
  3. Perform active listening.
  4. Make sure that his condition is normal for the situation he is going through.
  5. Provide support, praise his effort.
  6. Give him a break (1/2 hour) or change his task if deemed advisable. Once the shift is over or the rescue or rescue is finished, we must promote a relaxed meeting of the group of work (psychological relief or debriefing technique) in which participants are encouraged to: Narrate the facts lived. Talk about the feelings experienced. Inform him of the symptoms that he may be experiencing or may suffer in the next few days. Give them instructions on how to act on these symptoms.

This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

If you want to read more articles similar to Psychological Intervention in Catastrophes, we recommend that you enter our category of Social psychology.

Bibliography

  • Elena Puertas López. Civil Protection Magazine. nº5. 2000 Psychological intervention in war disasters.
  • José Manuel Montero Guerra. Roles of the Psychologist. September, nº 68, 1997 Psychological intervention in disasters.
  • Jose I. Robles and José L. Medina. Ed. Synthesis. Psychological intervention in emergency and disaster situations. Basque government. Isabel Vera. Civil Protection Magazine. nº8. 2001
  • Luz Gutierrez Gutierrez. Civil Protection Magazine. # 1. 2000 Practical Manual of Psychological Support in Emergency Situations.
  • Juan M. Fernández Millán. Ed. University Editorial Group First psychological aid. Spanish Red Cross.
  • Manuel Trujillo. Psychology for after a crisis. Ed. Aguilar.
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